新生儿颅内出血.ppt

IntracranialHemorrhage

oftheNewborn

(ICH)

新生儿颅内出血

Contentsmastered:ThemaincausesofneonatalICH颅内出血ClassificationandmanifestationNursingdiagnosisandnursingmanagementofneonatalICHPreventionofneonatalICH

DefinitionNeonatalintracranialhemorrhageiscranialinjure颅内损伤ofnewbornsduetoperinatalhypoxiaorbirthtrauma围生期的窒息产伤Theincidenceismorehigherinpremature早产儿Aseverediseaseinneonate

EtiologyandEpidemiologyofICHTrauma(epidural,subdural,orsubarachnoid)产伤硬膜外的，硬膜下的，蛛网膜下的Terminfantsfetalheadistoolargecomparedwiththesizeofthepelvicoutlet骨盆出口prolongedlabor/breech臀orprecipitantdeliveries急产Deliverywithmechanicalassistance机械性的辅助Asphyxia/Hypoxic-ischemicencephalopathy窒息Premature

Intracranialhemorrhage胎儿头部过分受压fetalheadistoolargeprolongedlabor产程延长Malpresentation胎位不正

Intracranialhemorrhage胎头吸引breechdeliveries臀牵引mechanicalinjuryIntracranialhemorrhage产钳助产precipitantdeliveries急产天幕、大脑镰撕裂、脑表浅静脉破裂

Primaryhemorrhagicdisturbance最初的出血障碍DICThrombocytopenia血小板减少neonatalvitaminKdeficiency维生素K缺乏(maternalphenobarbital苯巴比妥orphenytoin苯妥英钠)Congenitalvascularanormality先天性的血管异常Iatrogenichemorrhage医源性的出血(sucktioning,infusing,ventilating)

pathogenesis发病机制Hypoxic缺氧,asphysia窒息血管内压Hypoxemia低氧血症、hypercapnia高碳酸血症Capillaryinbrainischemicinjure脑内毛细血管缺血性损伤Capillaryinbrainrupturebleeding脑内毛细血管破裂出血动脉压Pressurepassivitybloodflow压力被动性血流Venaencephalivesselsrupturebleeding脑静脉血管破裂出血Cerebralvesselsexpand脑血管扩张动脉压

CommonClinicalSigns/SymptomsofICHChangeofconsciousness意识改变IrregularrespiratorypatternorapneaAbnormaleyessigns/movementPupilssigns瞳孔改变ChangeofmuscletoneOthers:jaundice,anemia,etcintracranialhypertension颅内高压

TherearethreemajortypesPeriventricular-intraventricular